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Climate change and sitting on tacks

A friend recently told me that her building in lower Manhattan flooded when Hurricane Sandy hit. We tsk-tsked about Climate Change, but when I asked her if she’d move, she shrugged. Apparently not.

So many of us shrug. We worry. We write letters. We march. But our daily lives pretty much remain the same. This reminded me of a story we quoted in Your Money or Your Life about a man, a doctor and a pain in the butt. Here’s an excerpt – and do ask, “What tacks am I sitting on?”:

“Suppose that I, a family doctor, make a house call to see a patient with a pain in the gluteus maximus — the buttock. In the course of my physical examination I find that the patient is sitting on a tack.

Were I to honor the implicit contract which postulates symptom suppression as the primary objective of my visit, I might administer a quarter grain of morphine, write a prescription for codeine pills, and leave instructions to call me in the morning . The morning report might be something like, “As long as I take the pills, it doesn’t hurt, Doc.”

In a few days, the pain medicine loses its effectiveness. Time and increasing dosage bring two new developments. The symptom suppression stops and side effects begin to appear. Symptoms may now include nausea and vomiting along with pain in the buttock. Faced with apparent failure of the drug approach, I might recommend surgery.

There are varying surgical solutions to the problem. I could sever the nerve which carries pain sensations from the buttock to the spinal cord, or I could perform a dorsal root rhizotomy. That’s a highly specialized neurological operation where we cut the sensory nerve as it enters the spine.

Alternatively, we could freeze the thalamus in the brain, which is thought to be the body’s pain center. I might send him to a pain control center where a group of specialists would give instruction on how to live with pain. As a last resort, I might suggest a prefrontal lobotomy, after which there be would be pain, but the victim wouldn’t notice it.

If I suggested getting up off the tack, the response would likely be, “But Doc, I make my living sitting on tacks.” [1]

Sound absurd? The American Health Foundation reports that some 400,000 new cases of occupationally related diseases are reported each year — and 100,000 Americans die of them. Furthermore, “the extent of occupational disease is thought to be underestimated because the connection between job and disease often goes unrecognized… ” [2]